Three-Dimensional Computed Tomography Measurements of Pedicle Diameters and Angles for the Safety of Posterior Cervical Spinal Instrumentation/ Posterior Servikal Spinal Enstrumantasyonda Uygulama Guvenligi Icin Pedikul Caplari ve Acilarinin Uc Boyutlu Bilgisayarli Tomografi Ile Olcumleri

• Published in: Southern Clinics of Istanbul Eurasia (SCIE) Vol. 35; no. 3; p. 243
• Main Authors: Borekci, Ali, Hicdonmez, Tufan
• Format: Journal Article
• Language: Turkish
• Published: KARE Publishing 01.09.2024
• Subjects: Care and treatment; CT imaging; Vertebrae, Cervical; Turkey
• ISSN: 2587-0998
• DOI: 10.14744/scie.2024.46690

Objective: The cervical pedicle screw fixation technique ensures rigid stabilization by offering superior correction capability for the restoration of the sagittal alignment of the cervical spine. Given the technical complexity of this procedure and its proximity to critical neurovascular structures, it is imperative for surgeons to thoroughly assess the patient's anatomy before undertaking pedicle instrumentation in the lower cervical spine. This comprehensive evaluation is crucial for minimizing risks and ensuring optimal surgical outcomes. Methods: In the present study, the widths, heights, transverse angles, and maximum lengths of pedicle screws of the vertebral pedicles between C3 and C7 in posterior cervical spinal instrumentation were bilaterally evaluated in 50 adult patients using preoperative four-way direct radiographs, thin-section computed tomography (CT) scans, and 3- dimensional CT (3D-CT) images. Results: The results revealed that pedicle height, pedicle width, and maximum screw length increased gradually as we descended caudally from the C3 vertebra to the C7 vertebra, whereas the transverse pedicle angle increased between C3 and C5 and decreased between C5 and C7. The mean maximum screw length varied between 29.7 mm and 33.1 mm. Conclusion: The findings of this study emphasize the importance of the widths, heights, transverse angles, and maximum lengths of pedicle screws for their appropriate placement into the pedicle in surgical procedures. Keywords: Cervical pedicle morphometry; cervical pedicle screw; computed tomography. Amac: Servikal pedikul vida teknigi omurganin sagital diziliminin restorasyonu icin yuksek korreksiyon kabiliyeti saglayarak rijit fiksasyona olanak saglar. Teknigin zorlugu ve onemli norovaskuler yapilara komsulugundan dolayi, cerrahlar alt servikal omurgada pedikul enstrumantasyonu yapmadan once hastanin bireysel anatomisini ayrintili olarak degerlendirmelidir. Gerec ve Yontem: Bu calismada, posterior servikal spinal enstrumantasyonda C3-C7 arasi vertebral pedikullerin genislikleri, yukseklikleri, transvers acilari ve pedikul vidalarinin maksimum uzunluklari, preoperatif dort yonlu direkt grafi, ince kesit bilgisayarli tomografi (BT) ve 3 boyutlu bilgisayarli tomografi (3B-BT) goruntuleri ile 50 eriskin hastada iki tarafli degerlendirilerek veritabani elde edildi. Bulgular: Elde edilen verilere gore C3 vertebrasindan C7 vertebrasina dogru kaudale dogru inildikce pedikul yuksekliginin, pedikul genisliginin ve yerlestirilebilecek maksimum vida boyunun giderek arttigi; transvers pedikul acisinin ise C3-5 arasi artip, C5-7 arasi azaldigi belirlendi. Ortalama maksimum vida uzunlugu 29.7 mm ile 33.1 mm arasinda bulundu. Sonuc: Bu degiskenlerin cerrahi uygulamalarda pedikul vidalarinin pedikule uygun yerlestirilebilmesi icin onemi vurgulandi. Anahtar Sozcukler: Bilgisayarli tomografi; servikal pedikul vidasi; servikal pedikul morfometrisi.